Divine Providence Village
NPI #1811352701 in Broomall, Pennsylvania
Provider Information
- NPI Number
- 1811352701
- Entity Type
- Organization
- Organization Name
- Divine Providence Village
- Primary Specialty
- Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
- Enumeration Date
- Dec 21, 2015
- Last Updated
- Dec 21, 2015
Practice Location
- Address
- 41 MEDIA LINE RD
- Address 2
- APT. A-2
- City
- Broomall
- State
- Pennsylvania
- ZIP Code
- 19008-1246
- Phone
- (610) 543-3380
Authorized Official
- Name
- MR. FRAN SWIACKI
- Title
- DIVISIONAL DIRECTOR
- Phone
- (610) 543-3380
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
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